Greenhouse Gas Emissions

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Warm Climate, Variable Health, Storm Warning Pierre Gosselin, MD, MPH Institut national de santé publique du Québec and Université Laval CAPE Montreal Conference 26 septembre 2009
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Warm Climate, Variable Health, Storm Warning Pierre Gosselin, MD, MPH Institut national de santé publique du Québec and Université Laval CAPE Montreal Conference 26 septembre 2009. Greenhouse Gas Emissions. - PowerPoint PPT Presentation

Transcript of Greenhouse Gas Emissions

  • Warm Climate, Variable Health, Storm Warning

    Pierre Gosselin, MD, MPHInstitut national de sant publique du Qubecand Universit Laval

    CAPE Montreal Conference

    26 septembre 2009

  • Density-Equalling Cartogram. Borders have been adjusted according to the countries cumulative CO2-equivalent emissions (1970-2000). Source: Gibbs et al. (2007).Greenhouse Gas Emissions

  • Density-equalling Cartogram WHO Regions scaled according to estimated mortality (per million people) in the year 2000, attributable to the climate change that occurred from 1970 to 2000. Source: Gibbs et al., 2007.Mortality caused by Climate Change, 2000

  • Quebec Data (1960-2003)

  • Projet #4

    Source: Ouranos, 2005.

  • Projet #4


  • Quebec Data In: valuation nationale sant et CC 2008Figure 2 : Nombre de catastrophes naturelles au Canada, de 1900 2002 Note : Seules les catastrophes hydromtorologiques sont associes au climat. Source : D. Etkin et coll., 200417.Figure 2 shows the number of climate-related and other natural disasters recorded in Canada between 1900 and 2002. According to the estimates published in the World Disasters Report, 2004, the total number of Canadians affected by natural disasters has increased from 79,066 between 1984 and 1993, to 578,238 between 1994 and 2003.

    Note : Only hydrometeorological disasters are associated with the climate.

    Source : D. Etkin et coll., 2004.

  • What health impacts were there in Quebec?In: valuation nationale sant et CC 2008

    Question, 2002-2003:

  • Several studies conducted in Quebec since 2003Researchers:Diane Blanger PhD (INSPQ, CHUQ)Bernard Doyon PhD (CHUQ)Pierre Gosselin MD MPH (INSPQ, CHUQ, U.Laval, Ouranos)

    Contributors:Belkacem Abdous PhD, Pierre Valois PhD (U.Laval), Philippe Poitras MSc (CHUQ), Mlissa Gigure MSc (INSPQ), Marie-France Sottile MSc (Ouranos), Luc Vescovi PhD (Ouranos), Philippe Gachon PhD (Ouranos), Daniel Martin PhD (CHUQ).

    Sponsors:Health Canada, Ouranos, MSSS, INSPQPublic Health Agency of Canada, IRSC, GEOIDE, Arcticnet.

  • Several studies conducted in Quebec since 2003Other studies: Kosatsky et al. of the Montreal Public Health Directorate (urban heat islands); Garneau et al. of UQAM (pollens and asthma);Nunavuk studies by Furgal et al. (various topics);Other Canadian studies including Quebec-related data.

  • 2005 AssessmentStudies conducted by INSPQ (Quebecs National Public Health Institute), 2003-20074 sectoral assessments (water, zoonotic/vectorial diseases, temperature, EMEs)General population perceptions, behaviourPublic health and municipal managers perceptionsMortality modelling and simulation14 reports available on-line at:

  • Heat wave alert systems (health network) have existed since 2004-2005 for southern Quebec.(93% of the population). Few tests performed.No systematic review of air conditioning in existing hospitals and shelters, but new standards for new buildings and renovations. No specific training or recommendations for medical staff regarding health care or medication.No public awareness/outreach programme. No real prevention or remediation programme for urban heat islands.

    2005 Assessment

  • Lack of public health emergency training Very good environmental monitoring system (storms, flooding, dams, rivers, forest fires, etc.)No follow-up of EME consequences; some short-term psychological follow-upSome preventive actions regarding flooding and road network, Northern housing and infrastructure.

    2005 Assessment

  • Very good drinking water monitoring system, but infrequent investigation of epidemicsSame for commercial and traditional foodstuffsPoor beach and swimming pool monitoring even though Quebec has 50% of Canadian pools!Preventive watershed-based approach in place but poorly financed.

    2005 Assessment

  • Quantitative water management is poorly implemented (outdated infrastructure, standards, swimming pools)

    No quality control for small water sytems and private wells (20% of population)

    Poorly organized public awareness/outreach

    2005 Assessment

  • 75% of adults take action to protect themselves from the heatThe proportion of air-conditioned dwellings has doubled since 1997; now at 35,8%.The most significant factor limiting access to air conditioning is household income.

    Public Perceptions and Behaviour

  • Projet #2

    Percentage of households with air conditioning in Quebec, 1972 to 2005 Source: ISQ (2005b) and Blanger et al. (2006a).

  • Access to air conditioning in 2005, in relation to the mean temperature warming trend (1960-2003) in southern QuebecSource: Blanger et al. (2006a), Yagouti et al. (2006)

  • Living alone is an excellent predictor for low income, chronic health problems and age over 65; these are the people who are most at risk in case of an Extreme Meteorological Event

    Two-thirds of people using walking aids or wheelchairs are unable to go shopping for groceries during a heat wave.

    Public Perceptions and Behaviour

  • Public Perceptions and Behaviour

  • Apartment dwellers and low-income people make great use of public parks and beaches during heat waves.

    Public Perceptions and Behaviour

  • Projet #2

    Percentage of domestic wood heating, per regionSource: Blanger et al. (2006)

  • Link Between Mortality And Climate

  • Mortality and Climate Relative to T

  • Historical Mortality Rate Modelling and Future Simulations ANNUALBonus:HeatWavesDeaths

  • Other questions, 2005: Where does the public stand? What changes are people ready for?

  • Very high recognition of environmental problems (water, air); some linkage to CCSame recognition level regarding existing vulnerabilities (poverty, unemployment, aging population) and their link with health conditions Most managers consider that CC adaptation will be a regional and provincial priority for the next 10 years, with varying importance depending on the region.Study of Public Health / Municipal Managers

  • Both manager categories (public health and municipal) are very aware of the negative impacts on infrastructure and economy, and on physical and mental health.

    Collectively, their appreciation of these impacts is clear, detailed and balanced.


  • Most managers believe that their regional institutions, in partnership, share the responsibility for CC adaptation.However, there is little field work, mostly limited to heat wave emergency plans. Most managers say they need (in this order): More practical information; Regional climate data; More political and institutional support; and Financial and human resources to move ahead.


  • Municipalities rely more on government information sources, less on scientific sources (Ippersiel & Morissette, 2004)More municipal (6+) than public health (1+) laws and regulationsLittle money tagged for prevention at the municipal level.


  • There is no unanimous certainty that a period of climate change has started, notably because of the media-peddled controversy on the causes of the warming trend natural vs anthropic.


  • Publics Intentions Regarding Certain Actions (2005)

  • Assessment Summary

    Action on housing and infrastructure will be crucial; standards must take CC into accountAvailability of shaded and cool areas in cities will have to increase; trees planted today will be useful around 2040 Not cutting them is a lot smarter.Supporting the poor, handicapped or chronically ill will be decisive to avoid social disastersNeighbourhood solidarity.

  • Assessment Summary

    The ground is fertile but it is necessary to continue tirelessly explaining the links between the actions that need to be taken, their causes and the climateOur major information effort: 22 reports, summaries, articles and book chapters (several thousand copies distributed); some 100 conferences and media events; hyperlinks on 6 websites

  • Assessment SummaryChapter 6 deals with Quebec; it summarizes all studies conducted in Quebec and includes recommendations.See and for the online version:

  • Several applied health research projects are being concluded within Ouranos (cyanobacteria, rural gastroenteritis, atlas of vulnerabilities, links between heat and air pollution, historical and future hospitalization modelling)Advice on guidelines being prepared for doctors and healthcare workers.

    Ouranos Health Research Programme 2006-2009

  • In developmentImportant support for adaptation workNew issues: urban heat islands and mortality, UV, zoonotic and vectorial diseases, strokes, high risk group characterization, housing, health impacts of Extreme Climatic Events, geosimulation of Lymes Disease

    Ouranos Health Research Programme 2009-2014

  • Reinforced health monitoring (for ECEs, infectious zoonotic and vectorial diseases, real time mortality) will be in place by 2012 Platform in development

    There will be studies, recommendations and demonstration projects on how to improve climate-related health care and services (institutional and home-delivered) Adaptation of health carerelated buildings and lands (1,700 buildings) according to new standards (demonstration projects)

    Health Action Plan 2007-2013

  • Health Action Plan 2007-2013Support demonstration projects for the creation of cool islands and for the prevention of EME risks to vulnerable, non-health care clients (schools, day care facilities, low cost housing, etc.)Training programme planned for network and non-network staff (pending needs identification)

  • Health Action Plan 2007-2013First health programme of this kind in Canada yet incomplete and imperfectNot much done yet on behaviour and its follow-up (and continuing reinforcement)Links need to be established with other existing health-related initiatives (UV, physical conditioning, sustainable development, transportation, etc.)Planned funding: $30 million, including 50% for demonstration projects initiated last year.


  • LESSONS LEARNEDNeed to start to change our thinking and words on the need for innovation for CC adaptation. The necessary technologies have been around for more than a century: bicycles (1817), railways (1804), tramways (1832), planning (~10,000 years), boats (~10,000 years), tax (~1,600 years) and walking (~2,000,000 years)What is needed instead is a strenghtening of public institution mandates, infrastructure and legal requirements.

  • LESSONS LEARNEDIt took 10 years to get ready to act, so we might as well start now, becauseWhen the money comes, wed better be ready to spend it wisely;It is essential to broadcast, explain and repeat the concepts, solutions, impacts and avoided costs, since human behaviour remains human.

  • LESSONS LEARNEDWhat will be lacking is the few billion dollars needed to offset the advertising drive to consume and emit GHGsLast year, the world automobile industry alone spent $70 billion on advertising and incentives out of a total world advertising budget of $450 billion Reducing GHG emissions remains the Number 1 adaptation measure, one which we owe our descendants.

  • Thank you for your attention

    ***International unfairness also found in Quebec*Global Warming is a reality in Southern Quebec

    This slide shows the evolution of mean annual temperatures in Southern Quebec between 1960 and 2003. Several regions have warmed up significantly, notably the western and central zones of southern Quebec. In these regions, mean annual temperatures have risen by 0.5 to 1.2C. In the eastern part of Southern Quebec, the warming rate has been lower less than 0.5C.

    Minimum temperatures have risen the most, notably winter temperatures. This change is higher in the North.

    1. MRCC scenario showing the number of days with Tmax > 30C, 1974-19992. MRCC scenario showing the number of days with Tmax > 30C, 2039-2063*MRCC scenario showing the number of days with Tmax > 30C, 2039-2063***********

    Fig. 2 Percentage of respondents with access to home air conditioning, relative to household income before tax. Random survey of 5,510 households; stratified according to the 15 public health regions, post-stratified according to genderCarefully crafted questionnaire: cognitive interviews, pre-testing, expert reviews, pilot.

    *Twice as many chances of owning an air conditioner if household earns $60k compared to $20k**Random survey of 5,510 households; stratified according to the 15 public health regions, post-stratified according to gender.Carefully crafted questionnaire cognitive interviews, pre-testing, expert review, pilot.

    *Fig. 3 Age pyramid, Quebec, 2001-2051 -- Reference scenario #1 Source: Quebec Institute of Statistics, 2003.

    Random survey of 5,510 households; stratified according to the 15 public health regions, and post-stratified according to gender.Carefully crafted questionnaire cognitive interviews, pre-testing, expert review, pilot.

    **The deeper the red, the poorer the neighbourhood.Blue dots are private swimming pools; green dots are public pools.*Figure 1 Seasonal death rate fluctuation percentage of mean daily number of deaths, Canada, 1974-1994.

    Source: Statistics Canada **Yearly mortality variation (%)****Figure X: Transportation Solutions to reduce the negative impacts of CC on the health and wellbeing of Quebeckers.

    Increase mass transit (car pooling, buses)Reduce private car use in major citiesMandatory car inspections (>7 years)Financial aid for green car purchasesIncrease number of bus sheltersIncrease tax on car purchases

    Agree totallySomewhat agreeSomewhat disagreeDisagree totally

    *Figure XX: Housing Solutions to reduce the negative impacts of CC on the health and wellbeing of Quebeckers

    Increase insulation requirements for houses and apartment buildingsPrevent building of houses, cottages and apartment buildings in risk-prone areas (e.g. flooding)Forbid wood heating on winter smog days**Drugs; technical aid for everyday life; institutional care; private accommodation; others.*Weve come a long way, but we have a long way to go*Weve come a long way, but we have a long way to go*Weve come a long way, but we have a long way to go